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surgical interventio

surgico del urinario

QuestionAnswer
Nephrectomy surgical removl of the kidney usually due to malignant tumors or large stones resulting in a non functionining kidney
what is invlovled in removal due to renal tumor? also removing the adrenal gland
Pre-op pre includes insertion of IV, prep skin, pt teach for recovery and home car, nurisng intervention
pre op nursing encourage fluid intake, though pt will be NPO after midnight the night prior to surgery, admin antibiotics as order, teach cl use of IS, deep breathing, couging, teach pt pain scale, TED hose, leg exercise, early ambulatio, provide emo support
post op mgm priorities include prevention and detection of hemorrhage, promotion of respiratory toilet and maintaining accurate I&O.
how do you monitor ing VS? Vital signs every 1 to 4 hours for the first 24 to 48 hours after surgery. A temperature above 101oF (38.3oC) is usually the first and only sign of infection; may also indicate atelectasis.
what is looked for in circulation? (a) Report decreased blood pressure, increased pulse, signs of poor perfusion (i.e., decreased pulses, increased capillary refill, cool and clammy skin), restlessness or sudden onset of flank pain.
What should the oxygen saturation be held at? Maintain blood oxygen saturation (SpO2) at 90% or above.
Note and record color of drainage from each tube and catheter and what else? (a) Label all drains, catheters clearly to avoid confusion when maintaining I&O. (b) Keep drainage catheters unclamped, unkinked, and below the level of Insertion.Secure all tubing to reduce movement/displacement at the site of insertion
) Change dressings as ordered includes? Note quality of drainage: quantity, color, odor. (b) Alert physician to purulent or foul-smelling drainage.
what is done for pt comfort and to ease mobility? Administer analgesics as ordered for comfort and to facilitate pulmonary toilet and ambulation. Provide support with ambulation, especially with use of narcotics
what precaution is made for drainage when pt is turned? Position patient every 2 hours as ordered, keeping patient off the operative side to avoid interference with wound drainage
sudden changes or frank presentation results in what? Contact the surgeon about any frank bleeding; a sudden decrease in urine output; pain, fever, chills or bloody, cloudy, or foul smelling urine.
what prevents nosocomial infection and lung problems? Encourage incentive spirometer and cough/deep breath to prevent atelectasis and hospital acquired pneumonia.
Nephrostomy : a catheter inserted into the kidney pelvis for drainage; requires surgical placement.
post op mgmg Maintaining patency of catheter. (b) Prevention and detection of hemorrhage. (c) Accurate I&O. (d) Meticulous skin care.
Prevent obstruction of the catheter with blood clots? irrigate the nephrostomy catheter using strict aseptic technique.(b) Gently instill no more than 5 ml of sterile saline solution at one time to prevent renal damage. Measure and record the amount and color of drainage from the nephrostomy catheter
clean and dry skin results from what post op care of nephrosomy change dressings frequently with sterile technique
Turn and position the pt to the affected side as orderd to facilitate? urinary drainage
what is expressly forbidden for a nephrostomy catheter? (5) Never clamp a nephrostomy catheter as acute pyelonephritis may result.
What is the limit of irrigation volume that can safely be instilled into a nephrostomy tube? 5ml.
pre op kidney transplant nursing interventions...? encourage pt to speak of fear over transplant/rejection 2) dialysis until successful surgery
post op mgm? prevent/detect hemorrhage, infection and rejection
Assess for signs of infection and rejection Apprehension, generalized edema. (b) Fever, increased blood pressure. (c) Oliguria and tenderness over the graft site
Administer medications to prevent rejection and infection cyclosporine (immuno suppresssive that allows enough immune response to fight infection), mycophenolate (anti-rejection)
Created by: redhawk101
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